TODAY, I WAS A PATIENT

I awoke this morning at 5:45 am. Why so early? I don’t know, but after sitting on the side of my bed for 30 minutes, I decided it was time to start my daily routine. By 7:00 am I was washed, dressed, and ready to go. It was then I noticed a familiar symptom I have had off and on since 1974 when I had my first kidney stone. There it was; that constant left lower abdominal pain accompanied by the sense I need to urinate AND have a bowel movement identical to the pain of the 20 or more kidney stones I’ve passed.

The pain didn’t let up. It gradually progressed to where I needed my wife to drive me to the ER. We arrived at 9:00 am, and the pain that was 9 out of 10 on the ride to the ER, suddenly began to  ease. By the time I was taken to a room, it was 2 of 10 and 90% better. I told the nurse I knew what was wrong, that I was much better, and could probably go home. The ER doctor had a “calmer head” and said we need to do several tests to see if a kidney stone was all I had. 

I agreed and got myself onto the gurney where I remained until 1:15 pm. As with any encounter with a health care facility, some interactions go well, but some do not. What follows next are the things that went well and those that did not meet up to standards.

THE GOOD: The nurses, medical assistants, lab techs, EKG tech, CT scan techs, and x-ray tech were all courteous and friendly. They all did their job very well. 

THE BAD: The first ER doctor saw me right away, but did a very, very cursory exam of my abdomen. She was in and out of the room in one minute or less. Her explanation was brief and without detail. She did not know I was a physician, but if I had not been, I would have been left with a lot of questions. 

THE GOOD: The CT techs got this “beached whale body” of mine on and off the exam table quickly and efficiently. The X-ray tech who did my abdominal X-ray on the gurney without any assistance was a pro. I merely had to roll from side to side.

THE BAD: When it came time to have blood drawn, I told the nurse I was a tough stick and techs usually have to use the back of my hand. She ignored my suggestion and went for my wrist instead. The blood sample was clotted so later, another tech had to come to redraw my blood.

THE GOOD: My patient gown was too small, and the room was very cold. They gave me two heated blankets to get warm. They felt good for about two minutes.

THE BAD: The blankets only partially covered me, cooled quickly, and for four hours I froze. There was never a time I was warm.

THE GOOD: The kidney stone pain went away.

THE BAD: Right before I was released, the pain returned but was tolerable. 

THE GOOD: The tests—CT, blood work, urinalysis, and X-ray diagnosed a 5 mm left ureteral stone.

THE BAD: The same tests showed I had several new stones in both kidneys, abnormal kidney function (worse than just a month ago), and either sludge (thickened bile) or stones in my gall bladder—a new finding!

THE GOOD: The pain went away completely. The shift ended for the ER doc, she left, and the new doctor came on duty. She was 100% more communicative. She explained the test results and thoroughly instructed me what to do after release. She said the nurse would be in to release me. That was at 12:45 pm.

THE BAD: The nurse who attended me all morning was to release me. Instead of taking the time to assist my discharge, she went to lunch. It was 12:30 pm, she told me to get dressed, offered no assistance, and left abruptly with a friend. She returned at 1:15 pm to find me dressed, sitting in my wheelchair at the door of my room waiting for her to “get my paper work completed.” I finally left at 1:20 pm. 

From the technology standpoint, my ER visit was efficient, professional, and diagnostically correct. The staff ordered the appropriate studies that were done without delay and quickly diagnosed my problem. From the professional standpoint, the original ER doctor was a poor communicator, spent little time with me, and did only a brief exam. The doctor who replaced her was 180° opposite in personality and was excellent. The nurse was courteous, but was absent much of the time. She had trouble drawing my blood. When I needed her help she was unavailable. My biggest complaint is the 30-plus minutes I waited to be released while she was at lunch. 

The GOOD thing is I was diagnosed and treated efficiently and competently. The BAD thing is the people with whom I dealt professionally did not perform at the level a patient should expect. Technologically, I was well evaluated and diagnosed. Professionally, the individuals fell  short of the standards of communication and empathy. 

Overall, my experience was positive. Human interaction with health care professionals, however, was lacking. I hope I don’t have to go to the ER again anytime soon, but if I do, I hope the human interaction is more attentive and meaningful.